Baker Mikayla J, Jiang Ziou, McClelland Collin, Lee Michael S
Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA.
Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA.
Eye (Lond). 2025 Feb;39(2):320-325. doi: 10.1038/s41433-024-03436-z. Epub 2024 Oct 27.
This retrospective case-control study from 2008 to 2022 aimed to determine the effect of adjunctive sodium bicarbonate (NaHCO) on treatment outcomes of and side effects of acetazolamide (ACZ) for the treatment of idiopathic intracranial hypertension (IIH).
SUBJECTS/METHODS: Retrospective data was collected via chart review. 288 eyes of 144 patients with IIH, including those taking ACZ alone (control group, n = 89) vs. ACZ and NaHCO (treatment group, n = 56). The primary outcome measure was time to IIH resolution. Secondary outcomes included retinal nerve fibre layer thickness (RNFL), visual field mean deviation (VFMD), visual acuity (VA), discontinuation ACZ, and patient-reported side effects of ACZ.
Cox proportional hazards model for the primary outcome yielded a hazard ratio of 0.800, which was statistically insignificant (95% CI, 0.57-1.13; p = 0.200). There was no significant difference between groups when comparing RNFL, VFMD, VA, surgical intervention, or discontinuation of ACZ. The treatment group was more likely to experience side effects from ACZ prior to starting sodium bicarbonate therapy (p < 0.001). Among the treatment group, 92.7% remained on NaHCO until IIH resolution, and 9 of 12 (75%) subjects reported significant improvement in ACZ-related side effects.
Sodium bicarbonate does not appear to impact treatment outcomes in patients taking acetazolamide for IIH. Sodium bicarbonate may represent a reasonable adjunctive medication to help mitigate acetazolamide-related side effects in this group of patients.
这项2008年至2022年的回顾性病例对照研究旨在确定辅助使用碳酸氢钠（NaHCO）对乙酰唑胺（ACZ）治疗特发性颅内高压（IIH）的治疗效果及副作用的影响。
受试者/方法：通过病历审查收集回顾性数据。144例IIH患者的288只眼，包括单独服用ACZ的患者（对照组，n = 89）与服用ACZ和NaHCO的患者（治疗组，n = 56）。主要结局指标是IIH缓解时间。次要结局包括视网膜神经纤维层厚度（RNFL）、视野平均偏差（VFMD）、视力（VA）、停用ACZ以及患者报告的ACZ副作用。
主要结局的Cox比例风险模型得出风险比为0.800，无统计学意义（95%CI，0.57 - 1.13；p = 0.200）。比较RNFL、VFMD、VA、手术干预或停用ACZ时，两组之间无显著差异。治疗组在开始碳酸氢钠治疗前更有可能出现ACZ的副作用（p < 0.001）。在治疗组中，92.7%的患者持续服用NaHCO直至IIH缓解，12名受试者中有9名（75%）报告ACZ相关副作用有显著改善。
碳酸氢钠似乎不会影响服用乙酰唑胺治疗IIH的患者的治疗效果。碳酸氢钠可能是一种合理的辅助药物，有助于减轻该组患者中与乙酰唑胺相关的副作用。
